Breath Holding Fails to Improve Robotic Lung Biopsy Results
In a randomized trial of 117 patients with peripheral lung lesions, sustained breath holding during robotic bronchoscopy did not significantly improve diagnostic yield compared with conventional ventilation (86.8% vs 92.2%). Lesion localization rates were also similar. Confirming the tool was inside the lesion produced a higher yield than merely touching it.
The STABLE trial randomized 117 people with peripheral lung lesions to standard ventilation or a standardized end-inspiratory breath hold while tissue was sampled using the Noah Galaxy robotic bronchoscopy system with augmented fluoroscopy and C-arm digital tomography. Mean lesion size was about 1.7 cm, and pneumothorax occurred in roughly 1.7% of cases. Radiation exposure was similar between groups, averaging 5.8 minutes and about 38.6 mGy.
Confirming the instrument was within the lesion yielded 95.9%, versus 85.0% when it only touched the lesion. The researchers described the work as preliminary and limited in size, and warned that results might not apply to nodules measuring 5 or 6 mm.
If confirmed, these findings could lead clinicians to prioritize real-time tool-lesion confirmation over breath-hold techniques, potentially simplifying some robotic bronchoscopy workflows. Patients with peripheral lung lesions may benefit if attention shifts toward dynamic imaging and precise sampling, though the trial's size means practice changes are likely to be cautious. Hospitals may weigh equipment and training needs, but no clear cost or access implications follow from this study alone.